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Total Force effort saves 3-day-old infant

  • Published
  • By Capt. Bruce Hill, Jr. and Master Sgt. Collen McGee
  • 433rd Airlift Wing
The Parkers are a U.S. Coast Guard family stationed at San Juan, Puerto Rico. They were excited and happy about the birth of their second child and had a very normal delivery.

That was until two hours after delivery when their newborn, Stuart Parker, began experiencing life threatening breathing complications that would send any loving father and mother into an emotional state of shock.

"It was a total surprise," said Mrs. Parker, the infant's mother. "Everything was perfect until two hours after his birth. I have yet to even hold him for the first time."

The Parker family, whose plan was to get Stuart to a proper medical facility that can best treat him for his condition, knew he needed to be transported to the United States for specific care that wasn't available at the Puerto Rican hospitals.

"Many of the doctors are educated in the U.S.," said Maj. John Bryant one of the two nurses on the 433rd Aeromedical Evacuation Squadron team. "They know what to do, but don't have the equipment to do it."

The Parkers turned to the internet for information on medical treatment and technology available in the states.

Initially they were going to Florida, but an internet search for the care needed for Stuart turned up Wilford Hall Medical Center in San Antonio, Texas, said Mrs. Parker

The Parkers had a Coast Guard medical liaison officer helping with arrangements that officially got a total force team headed to San Juan. Within hours, a Reserve Aircrew from McChord AFB, Wash., flying a C-17 from March ARS, Calif., was on the way to take a Lackland AFB, Texas Extracorporeal Membrane Oxygen Machine team from the 59th Medical Wing and a Reserve AES crew from the 433rd to transport the boy to WHMC.

"Stuart's condition was really up and down until the last 36 hours," said Lt. Seth Parker, Stuart's father, a U.S. Coast Guard Search and Rescue Controller, Sector San Juan. "Because of the ECMO system, Stuart's condition has been relatively stable."

Those last 36 hours included a few issues the Alamo Wing AE crew was along to solve. One of those involved equipment that prevented the ECMO from being used on the Puerto Rican ambulance. Here, AE personnel enlisted the help of the reserve maintainers on the C-17.

"The aircraft crew chiefs removed the hardware from the ambulance that was interfering with the ECMO machine," said Major Bryant.

According to Maj. Frances Robertson, nurse and medical crew director, the local driver was concerned about the vehicle remodel.

"I don't think the owner was going to be all that happy, but it had to be done and we got the approval through the AE cell at TACC (the Tanker Airlift Control Center) in case there was a repair bill to restore it," said Maj. Robertson.

Another equipment issue came up before Stuart could take the flight attached to the machine that replaces his heart and lungs until they can function again.

"They asked if we had an I-stat machine," said Major Bryant.

Major Bryant explained the I-stat is an instrument that operates as a combination monitor for blood glucose and the level of gases in the blood.

Major Robertson explained both are important for in flight monitoring of how the ECMO is working and, because Stuart was getting feedings intravenously in flight. It was important to monitor and make sure he wasn't getting too much or too little sugar.

The AE team had to locate one on the local economy and buy it and install it.

Once the ambulance was ready, and a monitor found, Stuart was taken to the waiting C-17.

At 12:04 a.m., Saturday, the Parkers, along with a 16-person combined medical crew arrived in Texas.

"It's been a blessing the 433rd could make it here and send a 16-person crew to support a tiny baby," said Stephanie Parker.

"The amount of dollars spent for one life amazed me," said Senior Airman Van Bell, a medical technician with the 433rd AES.

Because life is priceless, the Air Force places top priority on medical evacuation missions.

"We are going because this is a military dependent," said Major Robertson emphatically.

"The 433rd has a team of volunteers that are on-call for deployments," said Capt. Jerome LaValley, 433rd Airlift Wing Medical Service Corps officer. "When a mission comes up, we run down the list to see who can make up a team."

"Typically we try to maintain five people per team, a nurse and four med techs (medical technicians) to handle a mission that normally takes 12 to 24 hours to complete," said Captain La Valley.

Support for humanitarian missions can vary.

The five-person crew had two first timers who learned what humanitarian medical evacuation really meant on a personal level.

"When the father went up to the baby (in flight) it hit me, his baby was still alive because of our airlift," said Senior Airman Jayme McUlob.

Airman Bell found opportunity to learn from the ECMO team, and practice skills he's used only in training.

"I asked a million questions to everyone on the ECMO team from the doctors down to the respiratory therapist," said Airman Bell. "There were about five people on that crew and they each took at least 20 minutes to explain everything as if I was going to use it tomorrow."

The AES crew wasn't the only crew with members in a first-time role. The ECMO team leader was a first time team leader. Major Robertson explained that she went carefully through each task checklist as they attached Stuart to the machine and carefully monitored his condition throughout the flight.

Both Airmen are students in their civilian roles. Airman Bell is a nursing student and Airman McUlob is a student of respiratory therapy and works for a civilian ambulance company.

With learning and training being most of what they do, getting a chance to fly their first real life-saving mission gave them a new way to look at routine training.

"(When all you do is training,) sometimes burnout sets in," said Airman McUlob. "But when this opportunity comes, all those feelings go away."

"It gives you a realistic idea of what you want to achieve (with all the training you get)," said Airman Bell, "of what you want to be a part of."

The educational and life-saving flight went smooth, as did the landing.

"That was the longest descent ever," said Airman McUlob. "I kept waiting and waiting for it (the jolt from landing) and it didn't come."

Major Robertson said there was no bounce and the pilot landed so smoothly he didn't need to use his brakes.

Once on the ground, Stuart was transferred to another ambulance.

As Stuart was being loaded for transport to WHMC, Stuart's parents looked on from beside the aircraft.

Moments later they would follow their newborn to the hospital where it is hoped Stuart's critical but stable condition will improve.

"We believe he will be on ECMO for three to seven days," said Mrs. Parker. "We plan on staying here in San Antonio for up to two weeks. As soon as he's off the machine, I'll get to hold him.

"I can't wait," she said.